Barriers and Facilitators of Implementing Performance- Based Non- Financial Incentives to Improve Data Quality and Use: Using a Consolidated Framework for Implementation Research

Abstract

Abstract
Background: Evidence shows that recognizing the best performers in organizations can motivate workers to make other remarkable achievements. However, there was scant information regarding the barriers and facilitators of implementing performance-based non-financial incentives (PBNI) to improve health data quality and information use by district health workers in northwest Ethiopia. Aim: The main objective of this research was to analyze the factors that hinder or support the successful implementation of the Performance-Based Non-Financial Incentives (PBNI) system in order to enhance the quality of data and its utilization among district health workers in northwest Ethiopia.
Methods: The research conducted in the Wogera district of Northwest Ethiopia utilized a phenomenological qualitative approach. In order to collect data, a record of qualitative information was compiled, focusing on the obstacles and aids to the implementation of PBNI (Performance-Based Non-Financial Incentives) for improved data quality and usage. These insights were derived from discussions held during performance review meetings and health data-days throughout the implementation phase. Additionally, qualitative data was obtained through interviews with 13 individuals purposefully selected for their knowledge and experience in the subject matter. Subsequently, the interviews and information log were transcribed, translated into English, and subjected to coding, organization, and thematic analysis using the Consolidated Framework for Implementation Research domains with the assistance of Open code-4.03 software.
Results: Factors explored as facilitators of PBNI implementation include the presence of positive pressure to implement PBNI, the availability of networked communication, the social architecture of facilities, and the presence of self-motivation and competitive spirit. On the other hand, the barriers included the wrong perception of PBNI that the participants had at the beginning of the implementation process, the presence of different prioritized agendas, the absence of a platform and guideline to acknowledge and motivate best-performing individuals, the need to appraise the performance of individuals, case-teams, and health facilities to identify and reward them accordingly, and the subsequent cost associated with the appraisal process.
Conclusion: The need to appraise the performance of implementers to identify those who deserve the incentives, the cost associated with the appraisal process, and the staff's concern about the fairness and reliability of the performance evaluation process were a few challenges encountered. However, the data-day platform and the governments' interest in improving health data quality and information use are opportunities that future implementers can capitalize on. [Ethiop. J. Health Dev. 2023;37 (SI-1)]
Keywords: Performance-based, non-financial incentive, implementation research, Ethiopia